Provider Demographics
NPI:1306370341
Name:CHARRON, BETHANY (DO)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:CHARRON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41 BOX 4341
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0044
Mailing Address - Country:US
Mailing Address - Phone:757-553-7078
Mailing Address - Fax:
Practice Address - Street 1:128 E APPLE ST STE 3800
Practice Address - Street 2:WRIGHT STATE UNIVERSITY DEPT OF OB/GYN
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2902
Practice Address - Country:US
Practice Address - Phone:937-208-2287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205621207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology